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Low-level laser therapy for carpal tunnel syndrome: systematic review and network meta-analysis.
Cheung, W K W; Wu, I X Y; Sit, R W S; Ho, R S T; Wong, C H L; Wong, S Y S; Chung, V C H.
Afiliación
  • Cheung WKW; Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong.
  • Wu IXY; Xiang-Ya School of Public Health, Central South University, Changsha, China.
  • Sit RWS; Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong.
  • Ho RST; Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong.
  • Wong CHL; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong.
  • Wong SYS; Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong.
  • Chung VCH; Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong; School of Chinese Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong. Electronic address: vchung@cuhk.edu.hk.
Physiotherapy ; 106: 24-35, 2020 03.
Article en En | MEDLINE | ID: mdl-32026843
ABSTRACT

BACKGROUND:

Splinting is recommended by various organisations as a non-surgical first-line treatment for carpal tunnel syndrome (CTS), despite the limited evidence supporting its effectiveness. Previous studies on the effectiveness of low-level laser therapy (LLLT) have reported mixed results, and this systematic review aimed to resolve this controversy.

OBJECTIVE:

To perform a network meta-analysis (NMA) for evaluating the effectiveness of LLLT compared with other conservative treatments for CTS.

METHODS:

Eighteen electronic databases were searched for potential randomised controlled trials (RCTs). RCTs evaluating LLLT or other non-surgical treatments as an add-on to splinting were included. Included RCTs measured at least one of the following three outcomes with validated instruments pain, symptom severity and functional status.

RESULTS:

Six RCTs (418 patients) were included. NMA suggested that LLLT plus splinting has the highest probability (75%) of pain reduction, compared with sham laser plus splinting (61%), ultrasound plus splinting (57%) and splinting alone (8%). However, while LLLT plus splinting is significantly more effective than sham laser plus splinting for pain reduction, the magnitude is not clinically significant (Visual Analogue Scale mean difference -0.53cm, 95% confidence interval -1.01 to -0.05cm; P=0.03, I2=25%). The effect of LLLT plus splinting on symptom severity and functional status was not superior to splinting alone.

CONCLUSION:

The use of LLLT in addition to splinting for the management of CTS is not recommended, as LLLT offers limited additional benefits over splining alone in terms of pain reduction, reduction of symptom severity or improved functional status. PROSPERO for systematic reviews and meta-analyses registration number CRD42017082650.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Síndrome del Túnel Carpiano / Terapia por Luz de Baja Intensidad Tipo de estudio: Clinical_trials / Systematic_reviews Límite: Humans Idioma: En Revista: Physiotherapy Año: 2020 Tipo del documento: Article País de afiliación: Hong Kong

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Síndrome del Túnel Carpiano / Terapia por Luz de Baja Intensidad Tipo de estudio: Clinical_trials / Systematic_reviews Límite: Humans Idioma: En Revista: Physiotherapy Año: 2020 Tipo del documento: Article País de afiliación: Hong Kong
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